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[Dysphagia] Re: Shaker exercises



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Shaker R; Kern M; Bardan E; Taylor A; Stewart ET; Hoffmann RG; Arndorfer RC; Hofmann C; Bonnevier J . Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol, 272:G1518-22  1997 

Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real (19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P< 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham-exercise) subjects (P< 0.05). A similar effect was not found in the sham-exercise group. In normal
 elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening

AND

Shaker, R., Easterling, C., Kern, M., Nitschke, T., Massey, B., Daniels, S., Grande, B., Kazandjian, M., & Dikeman, K. (2002). Rehabilitation of swallowing by exercise in tube fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology 122(5):1314-1321. 
Shaker, R., Kern, M., Bardan, E., Arndorfer, R. C., & Hofmann, C. (1997). Effect of isotonic/isometric head lift exercise on hypopharyngeal intrabolus pressure. Dysphagia, 12(2), 107, 1997. 

Sharon Richards <noahsark322@yahoo.com> wrote:I would love to have information on the Shaker exercise program.  Is there documentation?


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<DIV>&nbsp;
<P class=MsoNormal>Shaker R; Kern M; Bardan E; Taylor A; Stewart ET; Hoffmann RG; Arndorfer RC; Hofmann C; Bonnevier J . Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol, 272:G1518-22<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>1997 </P>
<P class=MsoNormal>Earlier studies have shown that the cross-sectional area of the deglutitive upper esophageal sphincter (UES) opening in healthy asymptomatic elderly individuals is reduced compared with healthy young volunteers. The aim of this study was to determine the effect of a head-raising exercise on swallow-induced UES opening and hypopharyngeal intrabolus pressure in the elderly. We studied a total of 31 asymptomatic healthy elderly subjects by videofluoroscopy and manometry before and after real (19 subjects) and sham (12 subjects) exercises. A significant increase was found in the magnitude of the anterior excursion of the larynx, the maximum anteroposterior diameter, and the cross-sectional area of the UES opening after the real exercise (P&lt; 0.05). These changes were associated with a significant decrease in the hypopharyngeal intrabolus pressure studied in 12 (real-exercise) and 6 (sham-exercise) subjects (P&lt; 0.05). A similar effect was not found in the
 sham-exercise group. <U>In normal elderly subjects, deglutitive UES opening is amenable to augmentation by exercise aimed at strengthening the UES opening muscles. This augmentation is accompanied by a significant decrease in hypopharyngeal intrabolus pressure, indicating a decrease in pharyngeal outflow resistance. This approach may be helpful in some patients with dysphagia due to disorders of deglutitive UES opening<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p></U></P>
<P class=Default><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman; mso-bidi-font-size: 10.0pt">AND<o:p></o:p></SPAN></P>
<P class=Default><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman; mso-bidi-font-size: 10.0pt">Shaker, R., Easterling, C., Kern, M., Nitschke, T., Massey, B., Daniels, S., Grande, B., Kazandjian, M., &amp; Dikeman, K. (2002). Rehabilitation of swallowing by exercise in tube fed patients with pharyngeal dysphagia secondary to abnormal UES opening. </SPAN><B><I><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman\,BoldItalic">Gastroenterology 122(5)</SPAN></I></B><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman">:1314-1321. </SPAN><SPAN style="mso-bidi-font-size: 12.0pt"><o:p></o:p></SPAN></P><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA">Shaker, R., Kern, M., Bardan, E., Arndorfer, R. C., &amp; Hofmann, C. (1997). Effect of isotonic/isometric head lift exercise on hypopharyngeal intrabolus
 pressure. </SPAN><B><I><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman\,BoldItalic; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA">Dysphagia, 12</SPAN></I></B><SPAN style="FONT-SIZE: 12pt; FONT-FAMILY: TimesNewRoman; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA">(2), 107, 1997. </SPAN><BR><BR><B><I>Sharon Richards &lt;noahsark322@yahoo.com&gt;</I></B> wrote:
<BLOCKQUOTE class=replbq style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid">
<DIV>I would love to have information on the Shaker exercise program.&nbsp; Is there documentation?</DIV>
<P>
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